There’s very little evidence that “preventive” actions make a difference, especially in those over 65.
Bone density scans also are highly recommended but other measures (e.g., muscle tone, ability to rise from a chair) predict fractures more and bone density doesn’t predict hip fractures, as discussed here. I’d like to see references to articles showing that people on meds for cholesterol, high blood pressure, etc., actually experience different end points than those who are not screened. Often when you actually read those articles you find the relative differences are huge but the actual differences are barely noticeable. When you start quoting journal articles to doctors the conversation changes.
She has a remarkably frank comment about aging:
“When we’re young, aging looks sort of yucky; frankly, even though it is extremely un-P.C. to say so, it looks sort of yucky when we get there, too. Hence, the magical thinking around skin creams.”
It’s not clear what we’re to make of that comment. Is she saying that yes, older people are ugly and therefore worthy of discrimination?
But, she says, all these concerns about aging disappear when one enjoys the pleasure of holding “a six-pound newborn boy” against “a heart burnished with the patina of age.”
Probably true. As a single person, I get a lot of pleasure out of holding my cat or snuggling with the dog. Age is a non-issue. Just mutual acceptance.
Maybe I should try for an op-ed about that. Not as PC as grandmothers but surprisingly common.
This article reinforces stereotypes of seniors as soft, cuddly nurturers. Many people over 60 are childless. Many prefer to work for money rather than volunteer (especially for organizations that pay their executives handsomely, such as hospitals and nursing homes). Some just like to travel.
A geriatric psychiatrist should know better than to stereotype “older brains.” Some people take more risks as they get older; novelty-seeking is a personality trait. Having never been especially conscientious or maternal, I doubt that I’ll transform when I hit a magic number.
Here’s what he writes about his patient “Dora:”
“She and her husband spent several months and considerable treasure each year after retirement traveling to a bucket list of exotic locales, but found themselves feeling increasingly alienated from family and friends who did not share in their adventures. Their children complained that they seemed more interested in spending time with itinerant acquaintances than with their grandchildren. Several friends became reticent to invite them on weekend outings, fearing that any such plans paled in comparison with their many adventures.” (more…)
Many people are decrying the advancement of Donald Trump to front-runner for US President. Some observers claim to be shocked by the number of voters who respond to his simple, hard-line solutions. Some claim he’s just acting, but
there’s a reason he’s chosen to play thi s role. It works.
If we wonder why we got Donald Trump, we can look to the way people accept modern medicine. The Amazon summary of a new book, Snowball in a Blizzard by Steven Hatch, says
“The key to good health might lie in the ability to recognize the hype created by so many medical reports, sense when to push a physician for more testing, or resist a physician’s enthusiasm when unnecessary tests or treatments are being offered.” In his book Overdiagnosed, Gilbert Welch questions the usefulness of diagnostic tests. Study after study shows that annual medical exams don’t affect mortality rates.
The truth is, “preventive medicine” (sometimes written as “preventative medicine,” as if the extra syllable lends authority to a nebulous concept) doesn’t exist. Scans, screening and exams rarely prevent anything. They sometimes reduce risk and allow early detection. Sometimes the risk reduction is on the order of 3% or less, which most scientists would agree isn’t clinically significant. Often early detection doesn’t affect outcomes. In his book Less Medicine, More Health, Gilbert Welch explains that cancer comes in at least three varieties: the “birds,” which grow so fast you’re doomed by the time you’re diagnosed; the “turtles,” which grow so slowly you might be dead before you can do anything; and the “rabbits,” which have an impact when caught and treated in the early stages. That’s why so many women get cancer despite annual mammograms. (more…)
This article from PBS News says it all: age discrimination starts as early as 35. Researchers sent around resumes, changing only the birth date of the applicant. Older applicants got fewer invitations.
When companies were asked why this was happening, the a”reasons given include worries that they’re not good at technology, that they don’t have computer skills. There’s worries that they’re not active, that they’re slow, that they’re not willing to embrace change. There’s worries that they’re just going to leave…” And these reasons just aren’t true.
And AARP’s recommendations, it turns out, aren’t helpful. Why are we not surprised?
According to this article, AARP told people to write, “I’m willing to embrace change.” People who followed this advice got fewer callbacks.
I’m not surprised. I once told a client to remove the phrase, “Maintain an active lifestyle” from his resume. You’re calling attention to age – and emphasizing that you define yourself by age.
So what can you do?
They suggest, “Volunteer and take classes.”
I’d beg to differ.
I’d say to position yourself away from entry level jobs; you’ll still get discrimination but not as much.
And go back to school to study entrepreneurship. Get the entrepreneurial mindset going earlier rather than later.
An article appeared in Time Magazine: Startups for Seniors. I was hoping they were going to highlight seniors who started their own companies in response to age discrimination, but no: they talked about startups making devices to protect seniors in their own homes. Even worse, they referred to these seniors collectively as “Grandma,” as in, “I Grandma falls…” or, “If Grandma needs help…” http://time.com/3560459/startups-for-seniors/
Then there were mentions of “that ugly Christmas sweater your Gram-Gram got for you. I wrote about them in another post.
And from an article on social media, of all things: “For the first time, more than half (56%) of internet users ages 65 and older use Facebook. Yes: grandma and grandpa are now on Facebook.”
So now everyone 65 and older has grandchildren? Is this an extension of singlism?
Not sure how I feel about this article. It’s not easy to transport attitudes across cultures.
In some ways the stereotypes are reinforced, such as asking “elders” for advice. Being old doesn’t automatically make one wise.
But in general, shouldn’t everyone be treated this way? In a medical setting, everyone should be addressed by last name and title. But if everyone else is on a first name basis, why make the “elders” stick out?
It’s fine to serve “elders” first at a family or purely social event, but not everyone likes to be reminded of his or her status. In some contexts, special care comes across as patronizing.
I’m especially nervous about the advice to intrude on someone’s privacy by assuming they’re lonely and want company. No thanks! Nobody should be in a nursing home – they’re evil places. If you’re at a party and see someone who’s alone, it’s nice to seek them out; in fact, it’s a savvy networking strategy.
Age isn’t a useful marker here. Anyone can be lonely, physically limited, or able to deliver wise counsel. Focus on the person, not the age.
Responding to Abigail Zuger’s column in the New York Times. Zuger notes that today doctors spend most time prescribing for pre-illness, which means they try to predict the future.
I am amused by, “For people who feel fine… It is the patient … firmly planted in the here and now, while medical personnel spin wild tales of coming catastrophe…”
“In fact, our future of treating pre-illness will simply catapult us right back to a priestly past, as we offer up misty visions of the future and encourage the masses to see with us and act accordingly.”
Zuger’s image – emotional doctors versus patients demanding evidence – captures my experience perfectly. When I declined a mammogram, citing research in top journals, the doctor responded emotionally, literally throwing up her hands: “It must be better than nothing.”
Urging a bone density scan, she cited relative risk (50%) rather than absolute risk (3%). Outpatient surgical clinics require pre-op tests for despite published research consistently showing no difference in outcomes. Most doctors don’t know the Society for General Internal Medicine’s guidelines limit testing for asymptomatic adults.
Doctors eagerly embrace studies questioning the value of herbal or alternative options, but shrug off equally credible reports showing the low value of mainstream “preventive” medicine. In fact “preventive” really means “risk reduction” and often the reduction is so low as to be meaningless. Thus the line between science and magic become blurred, educated skeptics resist medical advice, and most doctors hate patients who know how to read statistics in the medical journals.